Marc Ryan

Impact Of OBBBA Cuts Two new analyses describe the looming impacts of the Medicaid and Exchange cuts in the One Big Beautiful Bill Act (OBBBA). Upcoming statutory limits on providers’ state-directed payments (SDPs) in Medicaid are expected to cost states tens of billions of dollars for state match and lower spending by double that or more. The analysis published in Health Affairs says 17 hard-hit states could see impacts of 10% to 25% of total annual Medicaid spending. The analysis outlined at least $51.8 billion in reductions across 36 states. A proposed rule would expand reductions beyond what is outlined in the OBBBA to all such SDPs. Federal policy changes and budget cuts are forcing states to scale back Medicaid benefits for immigrants. Because of looming cuts, California, Colorado, Illinois, Minnesota, New York, Washington and the District of Columbia have scaled back state-funded coverage for immigrants. The changes will also

States Turning To Managed Care For Medicaid Long-Term Care An excellent Modern Healthcare article on Medicaid long-term care. Twenty-four states contract with Medicaid managed care organizations to cover people who need long-term services and supports. This is a remarkable shift from decades ago when managed care covered largely only TANF welfare and related populations. States have turned to private delivery to save costs and reduce trends. However, some states are actually rolling back long-term managed care. Indiana and Nebraska recently ended insurer contracts amid provider concerns. #medicaid #longtermcare #managedcare https://www.modernhealthcare.com/insurance/mh-medicaid-managed-care-long-term-services State Initiatives To Reduce Healthcare Costs Growing Another interesting Modern Healthcare article on state efforts to reduce healthcare costs. Eight states have established cost growth targets. Enforcement ranges from hard penalties down to performance improvement plans and reporting. Some states are also looking to cap certain healthcare services and payer types. So far, there have been mixed reviews on state

Cuban Offers Ideas On Affordability Entrepreneur Mark Cuban, founder of Cost Plus Drugs, appeared before the Texas Legislature with affordability and reform ideas. They include: #healthcare #healthcarereform #cuban https://www.fiercehealthcare.com/regulatory/mark-cubans-recipe-affordable-healthcare-includes-these-5-policy-changes Cambia And Arkansas BCBS Affiliation Approved The Arkansas Insurance Department approved Arkansas Blue Cross and Blue Shield’s affiliation with Cambia Health Solutions, effective Oct. 1. The partnership will bring Cambia’s membership to nearly 6 million enrollees across six states. #bcbs #mergers https://www.modernhealthcare.com/insurance/mh-arkansas-blue-cross-cambia-health-approval — Marc S. Ryan

Hospitals Say Revenue Losses Will Mount With More Changes Hospital lobbies are turning up the heat on lawmakers given multiple funding reductions that threaten hospital finances. Impacts of the One Big Beautiful Bill Act will be $340 billion through 2034. But new rules proposed by the Trump administration would reform site neutral payments for imaging and enact reductions to drug reimbursement in Medicare for those with 340B status. That would mean another $681 billion loss over ten years. While I favor site neutral payments and some 340B reforms, it seems clear that all the reductions threaten to undermine providers. #hospitals #obbba #340b #siteneutral #medicaid #exchanges https://www.politico.com/news/2026/09/02/hospitals-say-coming-regulations-worse-than-medicaid-cuts-01060086 Centene To Exit Some Commercial Markets Centene subsidiary Health Net is pulling out of the commercial employer group market in California and Oregon. Additional article: https://www.modernhealthcare.com/insurance/mh-centene-california-oregon-commercial-group-plans/ #centene #employercoverage https://www.beckerspayer.com/payer/centenes-health-net-to-exit-commercial-group-market-in-california-oregon/ ICHRAs Now CHOICE The Centers for Medicare and Medicaid Services (CMS) has announced the rebranding

More Crippling News On Employer Healthcare Costs I told you about a number of business surveys projecting huge increases in healthcare costs in 2027. The bad news continues. A new survey underscores the trend. Marsh, formerly Mercer, says employers’ healthcare costs are projected to spike again in 2027. Without intervention, the hike would be 11%. With benefit adjustments and other interventions, the hike will be 8.2%. This echoes the Aon survey which said costs will rise 9.5%. In other news, only 60% of employer health plans cover GLP-1 drugs for obesity, down from 72% last year. This is from the Business Group on Health. Additional articles: https://www.fiercehealthcare.com/payers/employers-health-benefits-costs-could-rise-82-2027-marsh-survey and https://www.modernhealthcare.com/insurance/mh-employer-health-plans-glp-1-coverage/ #employercoverage #healthcare #coverage #costs https://thehill.com/policy/healthcare/6066452-employer-health-costs-spike-2027 Elevance Will Exit LA Medicaid Elevance Health’s Healthy Blue joint venture will close at year’s end, impacting 290,000 Medicaid enrollees. Louisiana will run a special enrollment period from Oct. 15 to Nov. 16 for impacted members.